Background: Maternal depression, substance use, and intimate partner violence can significantly impair maternal functioning and continues to be an international health priority. In particular, the longitudinal course of these risks or what percent of mothers experience recurrent episodes is not well known. Purpose: The purpose of this study was to examine the three year course of these factors among a cohort of adolescent mothers.  Sample: Data were derived from 113 adolescent mothers living in Southern California and participating in a larger RCT of the provision of home visitation services for families of newborns deemed at risk for child maltreatment and adverse health and developmental outcomes. The sample was ethnically diverse: 58% Latino, 14% Caucasian, 18% Black, 11% Asian/Pacific Islander, “other or unknown”.  Mean age was 16.7 (SD = 1.16); 41.6% 14-16 years of age. Methods: A structured interview containing standardized measures including the CES-D, Abuse Assessment Screen, The AUDIT, and DAST-10 was administered by trained research assistants to obtain information about severity of depressive symptoms, substance use, and intimate partner violence at delivery, 12, 24, and 36 month follow-up.  Results: Multivariable methods for longitudinal data, generalized estimating equations, revealed intimate partner violence was associated with higher odds for depression; Hispanic and Black participants reported lower odds of substance use compared to Non Hispanic white participants, and an elevation in depression was associated with greater odds of victimization.
Discussion: Findings indicated elevated depressive symptoms were common at initial assessment and almost half also had symptoms at 3 year follow-up. Predictors per time points differed suggesting identification and treatment must continue beyond the immediate postpartum period to prevent negative consequences for mothers and young children.  Although women of childbearing age interact with a number of service systems, no sector has assumed responsibility for the identification and treatment of MD and co-occurring problems and until the services are sensitized to the need, MD and the co-occurring problems of violence and substance use will continue to be under diagnosed and untreated.

Funding: National Institute on Drug Abuse (K01 DA15145)